The Clinical Research Of11Cases Of Patients With Limbic Encephalitis

Objective: To summarize and generalize the various types ofetiological factors, clinical symptoms, diagnosis and therapeuticexperiences of Limbic Encephalitis (LE) and what further improvementsare required for the recognition of LE, along with reducing diagnosticerrors or mistreatment, for clinical doctors.Methods: Patients of LE that were admitted to the neurologicdepartment of the first hospital attached to JLU (from November2012toJanuary2014) were used to conduct this respective study. Furtheranalysis and evaluation was carried out for their total clinical featuressuch as: age; gender; invasion forms; etiology; accompanying diseases;clinical symptoms; neuro-imaging; electroencephalogram; relativeantibody detection; diagnosis and identification; as well as treatment andprognosis.Results: Among the11patients of LE, there were4males and7females. The age of when invasion formed ranged from25to75years,and43.4in average. Clinical symptoms varied as follows: among the11cases,10cases behaved as psychical symptoms,4as consciousnessdisorders,6as epilepsy,4as memory disorders,3as central hypoventilation,3as fever,4as dysphoria,3as oral-lingual-facialdyskine-sias,3as restlessness of limbs,and3as hyponatremia.CSF of all11LE cases were examined for the relative antibody, theresults were as follows:2case with positive anti-Hu antibody,5withpositive anti-NMDAR antibody,4cases with positive anti-LGT1antibody. Among the11cases,1was diagnosed by lung cancer,1byovarian cysts，and1by hydatidiform mole. All patients were examinedby MRI, and6cases showed abnormal high signal in one or both sidesof hippocampus, insular lobe, inner side of temporal lobe, or frontal lobein T2weighed imaging and FLAR imaging. Among the11cases, theunique one with positive anti-Hu antibody was identified with lungcancer, the4cases with positive anti-LGI1antibody were free of tumor,and among5cases with the positive anti-NMDAR antibody, one ofwhich was diagnosed by ovarian cysts. All of the11cases showedabnormal results in long term video EEG examination, which wascritically important for the adjunctive diagnosis for the LE.Conclusion:①Possible LE should be taken into considerationwhen patients clinically showed symptoms of psychological andbehavioral abnormalities, temporary memory disorders, seizuredisorders, and central ventilation inadequacies in an acute or subacuteform.②MRI examination, long term video EEG, and relative antibodydetection in serum and cerebral fluid are essential for the clinically dubious LE for further diagnosis.③Thorough examination is requiredto ensure whether neoplasm exits after patients are diagnosed as LE withinfected causations are excluded. Further for PLE patients the timelyectomy of neoplasm combining with immunotherapy is necessary.